Abstract
Treatment with hypomethylating agents (HMAs) improves overall survival (OS) in patients who achieve a response of stable disease (SD) or better (complete remission [CR], partial remission [PR], or hematologic improvement [HI]). It is not well established if patients who achieve SD at 4-6 months of therapy should be offered different therapies to optimize their response or continue with the same regimen. Clinical data were obtained from the MDS Clinical Research Consortium database. SD was defined as no evidence of progression and without achievement of any other responses. Of 291 patients treated with AZA or DAC, 55% achieved their best response (BR) at 4-6 months. Among patients with SD at 4-6 months, 29 (20%) achieved a better response at a later treatment time point. Younger patients with lower bone marrow blast percentages, and intermediate risk per IPSS-R were more likely to achieve a better response (CR, PR, or HI) after SD at 4-6 months. Patients with SD who subsequently achieved CR had superior OS compared to patients who remained with SD (28.1 vs. 14.4 months, respectively, p=.04). In conclusion, patients treated with HMAs who achieves CR after a SD status had longer survival with continuous treatment after 6 months.
References
May 16, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lewis R SilvermanJames F Holland
Mar 15, 2006·Cancer·Hagop KantarjianHussain Saba
Apr 13, 2006·Blood·Bruce D ChesonHagop Kantarjian
Feb 24, 2009·The Lancet Oncology·Pierre FenauxUNKNOWN International Vidaza High-Risk MDS Survival Study Group
Jun 10, 2011·Cancer·Lewis R SilvermanJohn F Seymour
Jun 29, 2012·Blood·Peter L GreenbergDetlef Haase
Apr 16, 2013·Haematologica·Steven D GoreAlan F List
May 30, 2013·American Society of Clinical Oncology Educational Book·Rafael BejarRami S Komrokji
Dec 24, 2013·Blood·Mikkael A Sekeres, Corey Cutler
Jan 28, 2014·American Journal of Hematology·Guillermo Garcia-Manero
Citations
Sep 14, 2016·Journal of Oncology Practice·Vijaya Raj Bhatt, David P Steensma
Dec 16, 2016·Nuclear Medicine Communications·Xiaozhou YuWengui Xu
Oct 27, 2017·Expert Review of Hematology·Roberto CastelliGiorgio Lambertenghi-Deliliers
Aug 22, 2018·Hematological Oncology·Sotirios G PapageorgiouVasiliki Pappa
Jan 24, 2018·British Journal of Haematology·Xin DuPeilong Lai
Aug 2, 2017·Cancer·Amer M ZeidanSteven D Gore
Jun 8, 2017·Blood·Eytan M SteinMartin S Tallman
Jun 2, 2016·American Society of Clinical Oncology Educational Book·Rami S Komrokji
Jun 2, 2020·Expert Review of Anticancer Therapy·Jonathan FeldShyamala C Navada
Oct 31, 2019·JCO Precision Oncology·Aziz NazhaJaroslaw P Maciejewski
Mar 1, 2019·Proceedings of the National Academy of Sciences of the United States of America·Shuvojit BanerjeeRobert H Silverman
Dec 23, 2020·Cancer Medicine·Rami S KomrokjiMikkael A Sekeres
Jan 31, 2021·Cancers·Yan JiangMarie-Bérengère Troadec
Mar 1, 2021·Leukemia Research·Panagiotis T Diamantopoulos, Nora-Athina Viniou
Jul 23, 2021·Epigenomics·Anthi BouchlaVasiliki Pappa
Oct 13, 2021·Future Oncology·Amer M ZeidanRobert S Epstein